Friday, March 11 marks two years since the World Health Organization declared COVID-19 a global pandemic.
It was very, very intense and very stressful, but also a lot of team building through adversity, said Dr. Amy Beth Kressel, Medical Director of Infection Prevention and Antimicrobial Stewardship at Eskenazi Health.
We would do one thing and then literally the same day we would have to change something because everything was changing so quickly. The hospital and my colleagues and I really came together.
A lot has changed in Central Indiana since WHOs declaration just about every COVID-19 metric continues to fall.
At Eskenazi Health, Dr. Kressel said frontline workers were caring for two COVID-19 inpatients as of Friday morning. That is compared to somewhere between 130 or 140 COVID-19 inpatients at the height of the Omicron surge.
We were able to take care of our patients through a lot of teamwork and a lot of grace for each other, said Dr. Kressel. So thats the positive.
On the flip side, Dr. Kressel said there is one lesson she hopes is learned: the nations supply chain is broken and needs to be fixed.
Supply chains basically broke, said Dr. Kressel. Personal protective equipment, we have shortages of critical medicines, we were concerned about our ventilators Its not as critical now but the supply chain issues are not completely resolved.
Dr. Kressel said she hopes there will be genuine action to make hospitals and the health care system more resilient to a future pandemic or any sort of future crisis.
I really think resiliency is going to have to be baked in across all the systems, said Dr. Kressel.
Meanwhile in Monroe County, health officials agree the pandemic caught many sectors by surprise.
We didnt have resources in place and infrastructure in place for a lot of things that we have now, said Penny Caudill, Health Administrator for the Monroe County Health Department. It can be an eye opening experience Why didnt we have those things? Well, we didnt have the infrastructure. We didnt pay for the infrastructure. But we can do that going forward and certainly more money is being put into public health. I guess that thats a good thing to come from this.
Caudill said another positive to come out of the pandemic is more open lines of communication and better relationships.
Weve had good relationships with our community partners, with the hospital and the university, but certainly the pandemic has forged new ones, said Caudill.
Friday also marked the last weekly scheduled COVID-19 press conference for the city of Bloomington. Caudill said the county now has the tools and ability to quickly orchestrate another meeting if necessary.
My staff has been incredible the past couple years. Incredible, said Stephenie Mellinger, Administrator for the Madison County Health Department. They may not interact on a daily basis, but they did during this pandemic and so it was really great to see how the whole department came together.
Mellinger said she has done a lot of reflection in this past week leading up to the two-year milestone. While she does remember this day in history, she said she remembers another day more vividly.
I remember more clearly the first case we had in our county, which would have been two years next week, said Mellinger. It was March 17th and I remember not being surprised by it. It was just a matter of time. I mean, we were watching all of this unfold.
Now, eyes are set on the future of public health in Madison County. Mellinger said the pandemic led to the county getting its first-ever mobile unit.
That was a goal of mine and it happened sooner as a result, said Mellinger. I want it to be a health clinic on wheels.
For a little less than a year, the mobile unit has been making its way across Madison County providing a variety of services outside of COVID-19. It now operates four days a week.
We have plans bigger, better, greater plans for that mobile unit and I want to run the wheels off of it, said Mellinger. Definitely, there have been some good things that have come out of [the pandemic].
Three more Mainers have died and another 282coronavirus cases reported across the state, Maine health officials said Saturday.
Fridays report brings the total number of coronavirus cases in Maine to 232,293,according to the Maine Center for Disease Control and Prevention. Thats up from 232,011 on Friday.
Of those, 168,193have been confirmed positive, while 64,100were classified as probable cases, the Maine CDC reported.
One man and two women from York County have succumbed to the virus, bringing the statewide death toll now to 2,145.
The number of coronavirus cases diagnosed in the past 14 days statewide is 6,173. This is an estimation of the current number of active cases in the state, as the Maine CDC is no longer tracking recoveries for all patients. Thats down from 6,758 on Friday.
The new case rate statewide Saturday was 2.11 cases per 10,000 residents, and the total case rate statewide was 1,735.60.
The most cases have been detected in Mainers younger than 20, while Mainers over 80 years old account for the largest portion of deaths. More cases have been recorded in women and more deaths in men.
So far, 4,440Mainers have been hospitalized at some point with COVID-19, the illness caused by the new coronavirus.
Of those, 122 are currently hospitalized, with 23 in critical care and six on a ventilator. Overall, 83 out of 354 critical care beds and 266 out of 328 ventilators are available.
The total statewide hospitalization rate on Saturday was 33.17 patients per 10,000 residents.
Cases have been reported in Androscoggin (22,250), Aroostook (12,311), Cumberland (47,630), Franklin (5,602), Hancock (7,155), Kennebec (22,368), Knox (5,775), Lincoln (5,080), Oxford (11,006), Penobscot (26,879), Piscataquis (2,928), Sagadahoc (4,914), Somerset (9,430), Waldo (5,909), Washington (4,184) and York (38,862) counties. Information about where an additional 10 cases were reported wasnt immediately available.
An additional 525 vaccine doses were administered in the previous 24 hours. As of Saturday, 990,933 Mainers are fully vaccinated, or about 77.4 percent of eligible Mainers, according to the Maine CDC.
As of Saturday morning, the coronavirus had sickened 79,507,030people in all 50 states, the District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands and the U.S. Virgin Islands, as well as caused 967,126deaths, according to the Johns Hopkins University of Medicine.
More articles from the BDN
Hidalgo County on Friday reported four coronavirus-related deaths and 183 cases of COVID-19.
Of the four individuals who died due to the virus, two were not vaccinated, according to the report from the Hidalgo County Health and Human Services Department. The youngest person who died was a woman in her 40s from Pharr.
The people who tested positive are in the following age groups:
The county also reported 91 people are currently hospitalized with COVID-19, including 81 adults and 10 children.
Of the 91 people hospitalized with COVID-19, 31 patients are in intensive care units, all of them are adults.
On Friday, schools across Hidalgo County reported 12 students tested positive for the virus.
A total of 4,825 staff members and 16,584 students have tested positive for the virus since the county started reporting school-related infections on Aug. 18, 2021.
Since the pandemic began, 194,132 people have tested positive for the virus, and 3,846 people have died due to the virus in the county.
There are currently 1,072 reported active cases of COVID-19 in the county.
At City Hall on May 8, 2020, Dr. Allison Arwady, left, Commissioner of the Chicago Department of Public Health, listens as Chicago Mayor Lori Lightfoot holds a press conference to announce plans to re-open the city weeks after restrictions were imposed to curb the spread of the coronavirus that causes COVID-19 disease. (Terrence Antonio James / Chicago Tribune)
If the coronavirus has one singular goalrepeatedly infecting usits only gotten better at realizing it, from Alpha to Delta to Omicron. And it is nowhere near done. Omicron is not the worst thing we could have imagined, says Jemma Geoghegan, an evolutionary virologist at the University of Otago, in New Zealand. Somewhere out there, a Rho, a Tau, or maybe even an Omega is already in the works.
Not all variants, though, are built the same. The next one to trouble us could be like Delta, speedy and a shade more severe yet still trounceable with existing vaccines. It could riff on Omicrons motif, eluding the defenses raised by infections and shots to an extent weve not yet seen. It could merge the worst aspects of both of those predecessors, or find its own successful combo of traits. Each iteration of the virus will require a slightly different set of strategies to wrangle itthe ideal approach will depend on how sick are people getting, and which people are getting sick, Angela Shen, a vaccine-policy expert at Childrens Hospital of Philadelphia, told me.
Our actual response wont just depend on the mix of mutations that the virus lobs our way. It will also hinge on how seriously we take those changes, and what state the virus finds us in when it slams usimmunologically, psychologically. While the next spotlight-hogging variant is still brewing, we can sketch out, in broad and not-at-all-comprehensive strokes, a subset of the cast of characters that could arise, and what it would take to fend off each one.
Lets start with the worst-case scenario, because its also probably the least likely. A new variant checks each of the Big Three boxes: more transmissible, more deadly, and much more evasive of the defenses that vaccines and other SARS-CoV-2 flavors have laid down.
In this version of events, even immunized people could suffer high rates of severe disease; additional boosters might not mount a sufficient blockade. The chasm in protection between the vaccinated and unvaccinated would start to closeperhaps rapidly, if the new variant collides with us when many people arent up-to-date on their shots and population immunity is low.
Such a virus might be so strange-looking that some of our tests and many of our antibody-based treatments could stop working. Viral spread would also outpace what diagnostic tools we have left, obliterating contact-tracing efforts and making the pathogen harder to cordon off. Hundreds of thousands of people in the United States alone could lose their lives in a matter of months, as one recent analysis noted. Countless more would be hospitalized or saddled with the debilitating symptoms of long COVID. This future would feel most like the pasta near-reversion to the first year of the pandemic, Crystal Watson, a senior associate at the Johns Hopkins Center for Health Security, told me. And, accordingly, this future would launch the most dramatic response.
Read: The coronavirus will surprise us again
First, wed have to start cooking up a new vaccine, tailored to fit a sniper-style variants quirks. That alone would take at least three months, by shot-makers current best estimates, not counting the arduous process of rolling out the updated vaccine quickly and equitably. In the interim, if we wanted to avoid the worst impacts, wed have to lean heavily on our old standbys: high-quality masks, potentially mandated into use; restricted travel; capacity limits atpossibly even brief closures ofrestaurants, bars, and gyms. (Hopefully, by this point, good ventilation and air filtration would be more widespread too.) The government might need to fund efforts to develop and distribute new tests and treatments. If the outbreak couldnt be contained, essential spaces such as schools might consider shutting their doors againthough Natalie Quillian, the deputy coordinator of the White Houses COVID-19 response team, told me that, from the standpoint of the administration, we really dont see a scenario where schools need to close.
Thankfully, a variant quite this bad would be hard to come by. Viruses cant rejigger their genomes infinitelynot if they want to keep efficiently infecting their preferred hosts. Vineet Menachery, a virologist at the University of Texas Medical Branch, thinks the virus will probably chance upon ways to dodge immunity to a greater degree than Omicron did. But, he added, the question is, does it have to give up something else to do that?
Even if the virus remakes itself many times, we can expect that its offense will still knock up against some multilayered defenses. Slipping out of the grasp of antibodies isnt that hard, but just statistically speaking, I dont think its possible to escape T-cell immunity, says John Wherry, an immunologist at the University of Pennsylvania, a contributor to a recent report that modeled various scenarios for our future with COVID. The trick, then, would be rousing enough public will to use those backstop tools and duel the virus againnot a sure thing if a doom-esque variant appears anytime soon. The acceptability of policy X, Y, or Z is not going to be the same as it was before, Shen told me.
In a less catastrophic forecast, a variant wouldnt pose an epic triple threat. But it could still pummel a substantial fraction of the population by ratcheting up one trait at a time. That could be any of the Big Three, but consider two examples: a juice-up in immune evasion, or a surge in virulence. All else equal, each could spark waves of serious disease and push the health-care system back to a breaking point.
First, the evasive option. SARS-CoV-2 now faces huge pressure to find an immunological escape hatch. With so many people having been infected, vaccinated, or both, the coronaviruss success has started to lean heavily on its ability to sidestep our shields. This future could be an even more dramatic version of the recent Omicron wave: None of us, no matter how many shots weve gotten, would truly be impervious to infection, or maybe even to serious illness. Through sheer numbers alone, this variant would be poised to land a huge swath of people in the hospital, even if it wasnt, particle for particle, a more deadly threat. Depending on the extent to which the variant eroded vaccine effectiveness, especially against hospitalization and death, we might still need to update our shots and launch a massive revaccination campaign. From the view of the White House, a variant would have to pass a fairly strong threshold to want to do that, Quillian told me. Its a pretty extensive effort to go back and revaccinate the entire population.
In some ways, a more virulent variant that was still susceptible to vaccine-induced defenses could be simpler to deal with. We could expect that people who were up-to-date on their shots would be very well protected, as they were against, say, Delta. The focus would be on shielding the most vulnerable: the unvaccinated, the elderly, the immunocompromised, those with heavy or frequent exposures to the virusall of whom would likely benefit from more vaccine doses, and additional focused measures around masking, distancing, testing, and treatments. And perhaps our responses would remain siloed in these groups. It would probably take a while for us to reimpose restrictions on the general population, Watson, of Johns Hopkins, said.
Read: The COVID strategy America hasnt really tried
Maybe thats not surprising. If much of society remains swaddled in safety, many people wont see a point in reinvesting in vigilance. The suffering of the people who we are already cultured to see as sickly or close to deathor who are concentrated in already marginalized communitiescan be easy to overlook. If its the elderly, the immunocompromised, unfortunately, I think were not viewing them in the same light as we would if it was the whole population, Menachery, the UTMB virologist, said. Which groups ultimately end up shouldering the brunt of the viruss burden will dictate the extent of our response.
Perhaps more of us would be galvanized into camaraderie if a variant pulled a wild card and upped its virulence in an unexpected group. If young adults or children, for instance, suddenly became a prime target, I have to believe the response would be different, says Tom Bollyky, the director of the global-health program at the Council on Foreign Relations, and a contributor to the report on future-COVID scenarios. (Menachery thinks a sudden downshift into kids would be unlikelythats not a typical modus operandi for coronaviruses.)
Theres a third axis on which the virus could shiftsheer transmissibility. Some mutation, or combination of them, could make the virus a bit more efficient at zipping between bodies. But without an accompanying supercharge of virulence, or extreme immune evasion, Im not sure thered be much of a response, to be honest with you, Watson said.
Some people might feel motivated to sign up for a booster. A few localities might push for masking again. Or not. And should a bump in spreadability team up with a drop in virulence, the publics reaction might be more muted still. People might get sick, but with immunity on our side, the proportion of cases that wind up in the hospital would also dwindlea deceptively comforting statistic to see. I have a hard time believing anyones going to care, unless theres more severity, says Adam Lauring, a virologist at the University of Michigan. Perhaps wed see this variants annual hospitalization and death burden on par with or below the flus, a level of suffering that Americans have already implicitly (and perhaps misguidedly) decided is fine.
Read: Were entering the control phase of the pandemic
But souped-up transmissibility is an insidious parlor trick. It helps viruses catch entire populations off guard. Even a somewhat defanged variant can sow chaos if its given the opportunity to spread far and wide enough, and find the vulnerable among us. And wed still be in deep trouble if a fleet-footed variant hit us at a time when wed let our vigilance over vaccination slip, or if efforts to dose up the worlds population equitably were still lagging behind. Plenty of suffering can unfold outside of hospitals as well. Less-severe SARS-CoV-2 infections can still seed long COVID. Hours would still be lost to isolations and illnesses. And though population immunity might be higher than ever right now, protection isnt spread evenly: Too many Americans havent gotten any shots at all, and many of those who have remain vulnerable because of their age or health conditions.
Even if, somehow, the virus were to become completely, truly benign, total complacency could be dangerous. A virus we let spread is a virus that suddenly has more hosts in which to evolve, Geoghegan, the University of Otago virologist, told me. Among them might be immunocompromised individuals, who could harbor the virus long-term. It could tinker with its genome until, by chance, it comes up with the perfect combo of mutations, she said, and then roar back into the population at large. Menachery also worries about SARS-CoV-2s penchant for stewing and shape-shifting in other animal species. Thats what has the potential, he told me, to give us SARS-CoV-3to spark the next coronavirus pandemic.
We cant say when the next threat will appear, or how formidable it will be. But we do have some control over its emergence: The more chances we give the virus to infect us, the more chances we give it to change itself again.
A note to our readers
Two years ago today, the World Health Organization declared the Covid-19 outbreak a global pandemic. A week before that, this newsletter was born. Since then, weve been on a journey together braving waves of infections, experiencing sickness and loss, mastering the art of protecting ourselves, and continuously learning about a wily virus that seemed to surprise experts at every turn.
As the Omicron wave fades in the U.S. and as the W.H.O. begins exploring how and when to call an end to the global pandemic were making changes to this newsletter too.
Beginning next week, we will be switching to a less-frequent schedule, landing in your inbox Monday, Wednesday and Friday. We may pop in more frequently when theres big virus news you need to know about, or even return to a daily schedule if needed. Well also be using this change to cover the most important topics in more depth, bringing you insights from the Times newsroom and beyond.
Before we dive into todays newsletter, I want to say thank you to everyone who has followed along with us these last two years and express special gratitude to those who have written in to share their experiences. Im looking forward to navigating the next phase of the pandemic with you.
Jonathan
Looking back on the last two years may trigger feelings of anguish about missed opportunities, derailed life paths and lost time. But what if there was a way to get some of that time back?
For some perspective on time lost during the pandemic, and what we can do about it, I spoke to Tim Urban, the author of the blog Wait But Why. Our conversation has been condensed and lightly edited.
How should we look at time lost during the pandemic?
People are more resigned to having lost the time to Covid than they should be. People underestimate not only the amount that they can make up, but they can also get into a habit that multiplies the amount of time they have left with people they love and doing the things they love.
How so?
If you actually pick up a calculator and you calculate the amount of quality days or hours you spend with the people you love, it can look like a pretty depressing number.
So for example, I realized that living in a different city than my parents, I probably spend 10 quality days with them a year. Then I thought about the fact that my whole childhood, I was with them almost every day. So it hit me that 95 percent of the days I have with my parents in my life happened in my childhood. If I spend another 10 days a year with them, that adds up to about another year total over many decades.
Theres nothing I can do about human life spans, but the cool thing about that number whether with time spent with friends, family or a relationship is that you can change it, by huge multiples, just by changing the order of your priorities.
How does that work?
So, for example, if you see your parents 10 days a year, you can make it 20, whether its by coming home a few extra weekends or spending an extra week with them during the summer. You could also make 10 into 100 if you want to make a big change and move to the same city.
How should people think about missed opportunities during the pandemic?
When we look back on our life, we often see a branching tree of lives that we could have lived, paths that we could have gone down, things that we missed. And we often wallow in regret about these things. But you can also take that exact same reasoning and apply it to the future. What lies ahead of you is a lush tree of open life paths. They all belong to you at this moment and theres nothing stopping you from going in one of those directions.
So its so easy to look at the pandemic as a bunch of missed opportunities. But the further you go into the future, the less important these two years will become. If you can use the pandemic as a splash of cold water, or a slap in the face, and pick your life path and make better decisions going forward, you can look back and say, because of those two years, my life took a better course.
Whats something you lost over the pandemic and how have you tried to get it back?
My grandmother is 96, but shes still with it. Shes great to talk to and shes got great stories and a lot of wisdom. And during the pandemic, I wasnt really able to see her because she was on lockdown and because of her age, it was too dangerous.
March 12, 2022, 4:26 p.m. ET
But those lost moments actually spurred me to do something Ive wanted to for a long time. I took a recorder to her and recorded a bunch of stories from her. Thats exactly the kind of thing you want to do but just dont. So in some ways, making up for lost time during the pandemic can actually spur you to make really important decisions that maybe you should have made a long time ago.
We asked readers about the opportunities they missed because of the pandemic. Your responses were particularly touching this week. Thank you to all who wrote in.
I ended a relationship right before the pandemic and didnt feel comfortable dating during, given health concerns. Covid effectively wiped two years off my dwindling fertility clock, so Ive now started the process of pursuing single motherhood using donor sperm and artificial insemination. Its not the vision I had for my future, but I cant afford to wait. With supportive family and friends, I will make it work. Sarah, Boston
My father died in October 2019. In February 2020, I made a plan to honor his love of France and my love for him by walking solo from Le Havre hundreds of miles southward to the Mediterranean. I bought the plane ticket in 2020, canceled and rebought it many times. Ive kept my body ready for the journey for two years by running and doing several solo hikes. My French is much better than it was in 2020 as Ive trained while listening to French language podcasts. Now, finally, Im embarking on this journey. A ziplock of my fathers ashes are tucked in my backpack. Ill scatter them on French soil when I arrive at just the right spot, somewhere he might have loved, if he could still share a picnic with me. Cree LeFavour, Provincetown, Mass.
My husband and I had just started an immigration process to Canada when the pandemic began. The process kept on getting longer and longer. Now we have no idea what is going to happen and I even started seeing and feeling Canada farther from us a bit more every day. But Ive been learning new things and preparing myself to have better job opportunities. I just started a software development boot camp a few weeks ago. Ive used the pandemic as a great opportunity to go back to things I love that will also allow me to increase my chances of a better future in any country I finally end up living in. Erndira CB, Mexico City
The pandemic stole memories I could have made with my dad. For two years we skipped our annual visit and ski trip to keep him safe (hes 78). This February we showed up with gloves, hats and masks. We strapped on skis and flew down the mountain together, leaving the years of pandemic worry behind. Susan H., San Jose, Calif.
We were just forming a much needed friendship with another couple who are neighbors . Because of the pandemic, we had no contact for two years except occasional texts and brief greetings as we passed taking out trash or getting mail. We are trying to re-establish contact. I texted how much I had missed our interactions and asked if they were up to socializing yet in our pandemic world. In response, they invited us over for drinksthe first of what I hope will be many new contacts. Elaine Turner, Denver, Colo.
I missed two years of my late 20s. I dont know that Ill ever quite get them back. Ill never be that age again, that time of life again. So instead of thinking about where I should be, Im focused on what I want to do with the time I have. Now Im teaching English in Japan. Afterwards, I want to motorcycle Vietnam and learn to surf in Bali. Ive decided I cant wait for the pandemic to be over. I cant wait for the world. Im going to live my life while I still have the time. Luke, Okayama, Japan
The love of my life had planned a wonderful trip for the two of us, working around some of his health issues, and then Covid hit. While we waited and waited for travel to be safe, his condition deteriorated and he passed away almost a year ago. We cant get our plans back, but I may try to take our trip by myself when and if life ever becomes normal again. Lynn R., Houston, Texas
There were two additional coronavirus deaths in The Sun Chronicle area since the week ending March 3.
However, Attleboro did not respond to a request for an update so it could be more since Attleboro has the most cases, deaths and the biggest population.
The 10-community Sun Chronicle area includes Attleboro, Foxboro, Mansfield, North Attleboro, Norton, Norfolk, Plainville, Seekonk, Rehoboth and Wrentham.
That being said, the overall number of deaths may actually go down because the state is altering the way it counts coronavirus deaths.
A press release from the states Department of Public Health on Thursday said the definition of a coronavirus death will be tightened.
As a result 3,681 deaths will be trimmed from the list of 22,966 confirmed deaths bringing the total to 19,285.
We are adopting the new definition because we support the need to standardize the way COVID-19 (coronavirus) associated deaths are counted, DPH State Epidemiologist Dr. Catherine Brown said in the press release.
By the numbers
Level of transmission in The Sun Chronicle coverage area Low in Bristol County; Low in Norfolk County
Number of new cases for our 10-community coverage area since March 3, 2022 129.
Percentage positive for the 10-community area 2.17%
Percentage vaccinated with two shots 70.03%
Percentage vaccinated with booster 37.25%
Number of people currently hospitalized at Sturdy Memorial 2
Percentage hospitalized at Sturdy Memorial who are unvaccinated 0%
Number of deaths in The Sun Chronicle area since March 3, 2022 2
Number of total deaths in The Sun Chronicle area 370 (Attleboro did not report so the number is likely bigger)
Massachusetts level of transmission, according to the CDC Low
Percentage of positive cases in state 1.85%
Breakdown by community (first number is new cases, second is vaccination rates)
Attleboro 31, 66.11%
North Attleboro 21, 69.61%
George W. Rhodes can be reached at 508-236-0432.
OSWEGO COUNTY The Oswego County Health Department continues to offer COVID-19 vaccines for county residents and is integrating the service into weekly vaccination clinics.
Since early last year, Oswego County Health Department staff have held vaccination clinics at sites in every corner of the county to make the COVID-19 vaccine easily accessible for residents. Those efforts have resulted in nearly 23,000 shots administered by Oswego County Health Department staff.
Through collaborations with state and community partners, more than 70,000 one- or two-dose vaccine regimens have been completed and more than 40,000 of those individuals have received booster or third dose vaccinations.
With a majority of the county vaccinated, health staff are transitioning to include the COVID-19 vaccine as part of weekly vaccine clinics offered at the Nick Sterio Public Health Clinic in Oswego. Anyone seeking the COVID-19 vaccine, or other general immunizations, should call the Oswego County Health Department at 315-349-3547 or schedule a COVID-19 vaccine online.
To view a list of upcoming clinics and schedule an appointment, go to health.oswegocounty.com/vaccines and scroll down to the calendar to click on the date and dose needed.
The following upcoming clinics are scheduled:
Tuesday, March 15
12:30-3:30 p.m. Nick Sterio Public Health Clinic, 70 Bunner St., Oswego
Wednesday, March 16
3:30-5:30 p.m. Nick Sterio Public Health Clinic, 70 Bunner St., Oswego
Tuesday, March 22
12:30-3:30 p.m. Nick Sterio Public Health Clinic, 70 Bunner St., Oswego
Wednesday, March 23
3:30-5:30 p.m. H. Douglas Barclay Courthouse, 1 Broad St., Pulaski
Saturday, March 26
11 a.m. - 2 p.m. SUNY Oswego Marano Campus Center, 55 Rudolph Road, Oswego
Tuesday, March 29
12:30-3:30 p.m. Nick Sterio Public Health Clinic, 70 Bunner St., Oswego
Wednesday, March 30
3:30-5:30 p.m. Nick Sterio Public Health Clinic, 70 Bunner St., Oswego
At-home COVID-19 test kits will be distributed to individuals who are vaccinated at upcoming clinics. Test kits will be distributed while supplies last.
Face masks are required at all health care settings regulated by the state Department of Health, including the Oswego County Health Department and any vaccination site.
For more information, go to the Oswego County Health Departments COVID-19 page at health.oswegocounty.com/covid-19 or call the COVID-19 hotline at 315-349-3330.
Residents should contact their medical providers directly for personal medical advice related to COVID-19 vaccinations, booster shots or treatments.
Under New York State Public Health Law, the Oswego County Health Department is the local public health authority regarding the COVID-19 pandemic response within the County of Oswego. The Oswego County Health Department works closely with New York State Department of Health regarding COVID-19 monitoring, response, and reporting.
Lilongwe, 11 March 2022One year ago today, Malawi launched a COVID-19 vaccination campaign with vaccine doses it received from the COVAX Facility.
To date, 1,955,495 million doses of COVID-19 vaccine have been administered and an estimated 4.4% of the total population has been fully vaccinated. Efforts are underway to increase vaccine uptake to reach a wider proportion of the population.
Since the first shipments, the country has now received a total of 4,469,720 million COVID-19 vaccine doses; 55% (2,459,820 doses) of these from COVAX, 16% (706,800 doses) from the African Vaccine Acquisition Trust (AVATT), and 29% (1,303,100 doses) from bilateral deals and donations. Starting with one vaccine type Astrazeneca Malawi is now offering COVID-19 vaccination with three vaccines Astrazeneca, Janssen, and Pfizer
Malawi rolled out the COVID-19 vaccine in a phased approach, starting with health care workers and other priority groups which included, immigration officers, National Defense Forces, prison warders, prisoners, teachers, those 60 years old and above, and people with underlying health conditions. However, the vaccine roll-out was challenged at several levels, resulting in low uptake.
According to World Health Organization social listening survey, there was vaccine hesitancy due to misinformation, disinformation, and lack of general knowledge about the COVID-19 vaccines. Malawi also faced vaccine supply chain challenges, including a delay in vaccine supply, which resulted in COVID-19 vaccine stockout at the peak of the third wave - this setback was a missed opportunity to increase the number of vaccinated population. Malawi also experienced health system pressures to deliver multiple vaccine types, some with very short shelf-lives, while ensuring that health workers were trained on each vaccine specificities, and that vaccines were delivered within their lifetime
Despite the challenges, the Ministry of Health with support from partners such as GAVI, UNICEF, the World Bank and WHO, has made great efforts to increase the vaccine uptake through expanding vaccination sites, ensuring effective use of available stocks, pacing delivery of new vaccine stocks, mobilizing communities and addressing doubts and misinformation, training health workers, and providing additional support for low-performing districts to increase vaccine uptake said Dr Janet Kayita, Acting WHO Representative in Malawi. WHO congratulates Malawi on this important milestone, and will continue to support the government and its partners to achieve its goals.
In Oct. 2021, a joint Ministry of Health (MoH) and WHO-led partner multi-agency mission comprising of WHO, UNICEF, JSI and Gavi examined the root causes for the slow COVID-19 vaccine uptake in Malawi and recommended strategies both supply and demand-side - to scale up the uptake.
To increase vaccine demand, the country has deployed different vaccine delivery strategies. Besides having fixed vaccination sites, the country has also adopted periodic mobile, outreach and door to door vaccination campaigns.
In November, 2021, Malawi government with support from UNICEF and technical support from WHO, launched a COVID-19 Vaccine Express Program to reach all parts of the country including the remotest of the rural locations where community settlements are high. Following the vaccine express program, the country registered an increase in uptake of vaccines by 61%.
In a sub-set of low-performing districts with a high burden of COVID-19, WHO with UNICEF and health partners are supporting the Ministry of Health to enhance support supervision and enhance demand for the COVID-19 vaccine. Through WHO technical and financial support, the Ministry of Health conducts community engagement initiatives that target village health committees, traditional and religious leaders. The aim of the engagements is to orient the key community influencers on COVID-19 vaccine messages that highlight health benefits of the vaccine. The orientation also aims at addressing misinformation, myths and misconceptions surrounding the COVID-19 vaccines.
WHO continues to support the country to scale up COVID-19 vaccine uptake, which will protect against severe forms of disease, hospitalization and the emergence of variants. WHO is also support efforts to step up surveillance, genome sequencing capacity, and increase testing to facilitate early detection and response to clusters of cases. Support for efforts to adhere to public health and social measures is also continuing
Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.
It's now known that tinnitus may be an unexpected side effect of SARS-CoV-2 vaccination, and there is an urgent need to understand the precise mechanisms and best treatment for vaccine-associated tinnitus, researchers say.
As of mid-September 2021, 12,247 cases of tinnitus, or ringing in the ears, following COVID-19 vaccination have been reported to the Vaccine Adverse Event Reporting System of the US Centers for Disease Control and Prevention.
"Despite several cases of tinnitus being reported following SARS-CoV-2 vaccination, the precise pathophysiology is still not clear," write Syed Hassan Ahmed, third-year MBBS student, Dow University of Health Sciences, Karachi, Pakistan, and co-authors.
The researchers review what is known and unknown about SARS-CoV-2 vaccine-associated tinnitus in an article published online February 11 in Annals of Medicine and Surgery.
The researchers say cross-reactivity between anti-spike SARS-CoV-2 antibodies and otologic antigens is one possibility, based on the mechanisms behind other COVID-19 vaccine-induced disorders and the phenomenon of molecular mimicry.
"The heptapeptide resemblance between coronavirus spike glycoprotein and numerous human proteins further supports molecular mimicry as a potential mechanism behind such vaccine-induced disorders," they write.
Anti-spike antibodies may react with antigens anywhere along the auditory pathway and fuel an inflammatory reaction, they point out.
"Therefore, understanding the phenomenon of cross-reactivity and molecular mimicry may be helpful in postulating potential treatment behind not only tinnitus but also the rare events of vaccination associated hearing loss and other otologic manifestations," the authors say.
Genetic predispositions and associated conditions may also play a significant role in determining whether an individual develops vaccine-induced tinnitus.
Stress and anxiety following COVID vaccination may also play a role, inasmuch as anxiety-related adverse events following vaccination have been reported. Vaccine-related anxiety as a potential cause of tinnitus developing after vaccination needs to be explored, they write.
How best to manage COVID vaccine-associated tinnitus also remains unclear, but it starts with a well-established diagnosis, the authors say.
A well-focused and detailed history and examination are essential, with particular emphasis placed on preexisting health conditions, specifically, autoimmune diseases, such as Hashimoto thyroiditis; otologic conditions, such as sensorineural hearing loss; glaucoma; and psychological well-being. According to the review, patients often present with a history of one or more of these disorders.
"However, any such association has not yet been established and requires further investigation to be concluded as potential risk factors for vaccine-induced tinnitus," they caution.
Routine cranial nerve examination, otoscopy, Weber test, and Rinne test, which are used for tinnitus diagnosis in general, may be helpful for confirmation of vaccine-associated tinnitus.
Owing to the significant association between tinnitus and hearing impairment, audiology should also performed, the authors say.
Although treatments for non-vaccine-induced tinnitus vary significantly, corticosteroids are the top treatment choice for SARS-CoV-2 vaccine-induced tinnitus reported in the literature.
Trials ofother drug and nondrug interventions that may uniquely help with vaccine-associated tinnitus are urgently needed, the authors say.
Summing up, the reviewers say, "Although the incidence of COVID-19 vaccine-associated tinnitus is rare, there is an overwhelming need to discern the precise pathophysiology and clinical management as a better understanding of adverse events may help in encountering vaccine hesitancy and hence fostering the COVID-19 global vaccination program.
"Despite the incidence of adverse events, the benefits of the SARS-CoV-2 vaccine in reducing hospitalization and deaths continue to outweigh the rare ramifications," they conclude.
The research had no specific funding. The authors have disclosed no relevant financial relationships.
Ann Med Surg. Published online February 11, 2022. Full text
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